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Failure to thrive

Scott D Krugman1, Howard Dubowitz

  • 1Department of Pediatrics, Franklin Square Hospital Center, Baltimore, Maryland 21237, USA. scott.krugman@medstar.net

American Family Physician
|September 19, 2003
PubMed

Insights

Failure to thrive (FTT) requires prompt diagnosis and intervention to prevent malnutrition. Careful plotting of growth parameters and a thorough history are key to identifying and managing FTT in infants and children.

Area of Science:

  • Pediatrics
  • Primary Care Medicine
  • Developmental Pediatrics

Background:

  • Failure to thrive (FTT) is a common pediatric concern encountered in primary care.
  • It can stem from medical, social, or environmental factors, including parental neglect or over-attentiveness.
  • Distinguishing FTT from normal growth variations, such as percentile shifts in healthy infants or specific growth patterns in conditions like Down syndrome, is crucial.

Purpose of the Study:

  • To outline the diagnostic approach to failure to thrive in primary care.
  • To emphasize the importance of early identification and intervention for preventing adverse outcomes.
  • To guide the management strategies for infants and children with FTT.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for FTT.
  • Emphasis on serial plotting of growth parameters during routine checkups.
  • Guidance on utilizing thorough patient history to determine etiology.
  • Recommendations for caloric supplementation and selective laboratory evaluation.

Main Results:

  • Many cases of FTT are missed without careful growth monitoring.
  • A detailed history is the most effective tool for identifying the cause of FTT.
  • Catch-up growth requires approximately 150% of the caloric needs for the *expected* weight.
  • Laboratory tests and hospitalization are infrequently necessary.

Conclusions:

  • Prompt identification and management of FTT are essential for optimal child development.
  • Caloric intervention is the cornerstone of treatment for FTT.
  • A multidisciplinary approach is recommended for persistent or severe cases of FTT.

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